Shared Care

A traffic light system, the RAG List, defines the responsibility for prescribing and monitoring medicines between primary care and specialists.

When clinical and/or prescribing responsibility for a patient is transferred from specialists to the GP, the GP should have full confidence to prescribe the necessary medicines. Therefore it is essential that transfers of care involving medicines should not take place without the sharing of information with the individual GP and their mutual agreement to the transfer of care.These are not rigid guidelines, GPs and specialists may agree to work outside these guidelines if a discussion to agree this has taken place.

RAG List

RAG List October18

If you receive a request to prescribe in the absence of a shared care guideline, which you consider inappropriate please complete a Hospital Prescribing Reporting Form.

RED: Prescribing remains the responsibility of the specialist and the hospital pharmacy should arrange supply of the medicine.

AMBER: With the GPs agreement, prescribing can be transferred at an appropriate time from the specialist to the GP but there continues to be shared involvement in monitoring and managing treatment.

GREEN: Suitable for initiation by GPs or initiation on the recommendation of a specialist. 
  

Pan Mersey APC have a slightly different catorgisation of medicines. Please see the Pan Mersey APC website for further information.

During the merger process the formulary will be reviewed on a chapter by chapter basis and the Pan Mersey APC categorisation adopted for each reviewed chapter. 

Shared Care Protocols

Safe management of medicines for patients requires clearly defined responsibilities between the GP and the specialist for monitoring and managing treatment. 

For Cheshire & Wirral Partnership NHS Foundation Trust guidelines & policies relating to mental health, please visit: www.cwp.nhs.uk/resources/policies 

Drug Indication
Apomorphine Injection Idiopathic Parkinson’s Disease
Atomoxetine ADHD in Children and Adolescents
Auranofin Rheumatoid arthritis and other rheumatological conditions
Azathioprine Dermatology conditions
Azathioprine Rheumatoid arthritis and other rheumatological conditions
Azathioprine and 6-mercaptopurine Inflammatory bowel disease
Ciclosporin Dermatology
Ciclosporin Rheumatoid arthritis and other rheumatological conditions
Colistimethate (nebulised) Bronchiectasis
DMARD Monitoring Summary

 

Fosfomycin (oral) Urinary Tract Infection (Adults)

Gonadorelin analogue and gonadotrophin-releasing hormone (GnRH) antagonists

Prostate cancer
Gonadorelins Endometriosis and uterine fibroids
Hydroxychloroquine Rheumatoid arthritis and other rheumatological conditions
Leflunomide Rheumatoid arthritis and other rheumatological conditions
Lisdexamfetamine ADHD in children and adolescents
Melatonin Sleep disorders in children and adolescents
Mesalazine and other aminosalicylates Inflammatory Bowel Disease (Adults)
Methotrexate Crohn’s Disease
Methotrexate (subcutaneous injection) Rheumatoid arthritis and other inflammatory diseases
Methotrexate tablets Asthma and sarcoidosis
Methotrexate tablets Rheumatoid arthritis and other rheumatological conditions
Methylphenidate ADHD in Children and Adolescents
Metolazone Chronic Kidney Disease (Adults)
Metolazone Refractory Heart Failure (Adults) 
Mycophenolate Rheumatoid arthritis and other rheumatological conditions
Mycophenolate Pemphigus and other dermatological diseases
Penicillamine Rheumatoid arthritis and other rheumatological conditions
Rasagiline Parkinson's disease
Rotigotine Parkinson's disease
Rivastigmine Treatment of mild/moderate Alzheimer's disease

Sodium Aurothiomalate (I.M)

Rheumatoid arthritis and other rheumatological conditions

Sodium Chloride Oral supplement

For neonates and children
Stiripentol

Dravet syndrome in Children and Adolescents

Sulfasalazine

Rheumatoid arthritis and other rheumatological conditions

Please Note: Documents which are past their review date will only remain on the website if they are still clinically relevant.